Frailty and Associated Factors among the Elderly in Vietnam: A Cross-Sectional Study

Background: Frailty syndrome is common among older people and can lead to various adverse consequences such as falls, cognitive decline, disability, dependent living, increased mortality, excessive drug use, and prolonged hospital stays. Objectives: This research determined the prevalence of frailty and associated factors among older adults in Vietnam. Methods: A cross-sectional study was conducted on 584 older adults across five Ho Chi Minh City wards from November 2020 to January 2021. Based on the modified Fried frailty scale, the participants were divided into three categories: robust, pre-frail, and frail. A chi-square test (or Fisher’s test) examined the relationship between frailty categories and other variables. Multivariable logistic regression used variates with a cut-off of p ≤ 0.05 in the univariate analysis. Results: The prevalence rates of frailty and pre-frailty were 19% and 64%, respectively. The most common frailty component was weak grip strength (63.9%), followed by slowness (36.1%), weight loss (21.6%), low physical activity (19.5%), and exhaustion (18.5%). In addition, the prevalence of frailty was significantly associated with age, BMI levels, living alone, and sarcopenia. Conclusion: The community’s prevalence of frailty among older adults is high. Frailty can lead to many adverse consequences for the elderly. As there were some modifiable factors associated with frailty, it should be assessed in older people through community-based healthcare programs for early diagnosis and management

Transcatheter Aortic Valve Replacement in Patients ≥80 and <80 Years of Age with Aortic Valve Stenosis at Moderate Surgical Risk: Findings from an Observational Study in the Vietnamese Population

Objectives: The increasing number of elderly patients with severe aortic valve stenosis undergoing transcatheter aortic valve replacement (TAVR) has prompted concerns regarding their clinical outcomes compared with the younger population. This study evaluated the outcomes of TAVR on the basis of age group (<80 or ≥80 years) among Vietnamese patients with severe aortic valve stenosis at intermediate surgical risk. Methods: From March 2017 to December 2022, 21 patients ≥80 years of age and 69 patients <80 years of age underwent TAVI at a single center. Clinical characteristics, procedures, and outcomes at 30 days and 1 year were compared with the Valve Academic Research Consortium (VARC-2) criteria. Results: Patients ≥80 years of age had a higher prevalence of comorbidities but no significant differences in other clinical characteristics and procedures. No statistically significant differences were observed in procedural mortality (4.8% vs. 0.0%, P = 0.233), 30-day mortality (5.0% vs. 1.5%, P = 0.405), and 1-year mortality (11.8% vs. 3.7%, P = 0.241) between age groups. Major endpoints at specified time points also showed no significant differences. Conclusions: TAVR in patients with aortic stenosis at intermediate surgical risk has similar clinical outcomes at 30 days and 1 year, according to VARC-2 criteria, with no statistically significant age-associated differences (≥80 vs. <80 years). However, further studies with larger patient populations are needed to better understand the effects of age on TAVI outcomes in patients with similar characteristics

Methods to discriminate primary from secondary dengue during acute symptomatic infection

Abstract Background Dengue virus infection results in a broad spectrum of clinical outcomes, ranging from asymptomatic infection through to severe dengue. Although prior infection with another viral serotype, i.e. secondary dengue, is known to be an important factor influencing disease severity, current methods to determine primary versus secondary immune status during the acute illness do not consider the rapidly evolving immune response, and their accuracy has rarely been evaluated against an independent gold standard. Methods Two hundred and ninety-three confirmed dengue patients were classified as experiencing primary, secondary or indeterminate infections using plaque reduction neutralisation tests performed 6 months after resolution of the acute illness. We developed and validated regression models to differentiate primary from secondary dengue on multiple acute illness days, using Panbio Indirect IgG and in-house capture IgG and IgM ELISA measurements performed on over 1000 serial samples obtained during acute illness. Results Cut-offs derived for the various parameters demonstrated progressive change (positively or negatively) by day of illness. Using these time varying cut-offs it was possible to determine whether an infection was primary or secondary on single specimens, with acceptable performance. The model using Panbio Indirect IgG responses and including an interaction with illness day showed the best performance throughout, although with some decline in performance later in infection. Models based on in-house capture IgG levels, and the IgM/IgG ratio, also performed well, though conversely performance improved later in infection. Conclusions For all assays, the best fitting models estimated a different cut-off value for different days of illness, confirming how rapidly the immune response changes during acute dengue. The optimal choice of assay will vary depending on circumstance. Although the Panbio Indirect IgG model performs best early on, the IgM/IgG capture ratio may be preferred later in the illness course